肝硬化食管静脉曲张的替代诊断方法  

Alternative methods for diagnosis of esophageal varices in patients with liver cirrhosis

作　　者：邓晗[1,2] 祁兴顺[2] 朱强[3] 郭晓钟[2] 

机构地区：[1]大连医科大学,辽宁大连116044 [2]沈阳军区总医院消化内科,沈阳110840 [3]山东省立医院消化内科,济南250021

出　　处：《临床肝胆病杂志》2016年第8期1468-1473,共6页Journal of Clinical Hepatology

摘　　要：食管静脉曲张(EV)破裂出血是肝硬化最为严重的并发症之一。上消化道内镜(UGE)是诊断EV的金标准,但为侵袭性检查。目前,已经报道了很多诊断EV的替代方法,包括血清学模型、超声指标、肝脏及脾脏硬度检测、食管胶囊内镜、核磁共振和CT等。综述了这些替代方法诊断EV的准确度及其临床意义。认为超声指标(脾门指数、门静脉充血指数及血小板与脾直径比值)、脾脏硬度检测、CT和食管胶囊内镜诊断EV的准确度较高,故可考虑应用于临床实践以减少UGE的使用。Esophageal variceal bleeding is one of the most serious complications of liver cirrhosis. Upper gastrointestinal endoscopy（ UGE）is the gold standard for the diagnosis of esophageal varices,but it is invasive. Recently,several studies have reported some alternative methods for the diagnosis of esophageal varices,including serological model,ultrasound parameters,liver and spleen stiffness measurement,esophageal capsule endoscopy,nuclear magnetic resonance,and computed tomography. This article reviews the accuracy of these methods in the diagnosis of esophageal varices and their clinical significance. Ultrasound parameters（ splenoportal index,congestion index of the portal vein,and platelet count / spleen diameter ratio）,spleen stiffness measurement,computed tomography,and esophageal capsule endoscopy are accurate in the diagnosis of esophageal varices,and therefore,they can be applied in clinical practice and the application of UGE should be reduced.

关 键 词：肝硬化 食管和胃静脉曲张 诊断 

分 类 号：R575.2[医药卫生—消化系统]